Connecticut MLR disclosure to insurance applicants

Oct 02, 2018

Connecticut

Fully Insured and Self-Funded

Legal and Compliance

Health insurers in Connecticut are required under state insurance law1 to disclose Medical Loss Ratio (MLR) to insurance applicants with each individual or group health insurance application for coverage.

UnitedHealthcare prepared the enclosed letters outlining MLR for 2017 to use with your Connecticut UnitedHealthcare and Oxford fully insured and self-funded clients.

Please notify your Connecticut UnitedHealthcare and Oxford clients about this information using the enclosed letters, as appropriate, and remind clients of their requirement for sharing this information with their employees.

Note that the MLRs reported here are not to be confused with the final federal MLR results for 2017 reported to the federal government in the second quarter of 2018.

The Connecticut MLR is defined as the ratio of incurred claims to earned premium for the prior calendar year for managed care plans issued in the state. It represents the percentage of total premium dollars that the insurer has spent on health care and activities to improve health care quality versus the percentage the insurer spent on claims. It limits claims to medical expenses for services and supplies provided to members, excluding expenses for stop loss coverage, reinsurance, member educational programs, and other cost containment programs or features.

The Connecticut MLRs are as follows:

UnitedHealthcare Insurance Company Medical Loss Ratio (MLR)

Year

State MLR

Federal MLR - Small Group

(1 to 50 eligible employees)

Federal MLR – Large Group

(51+ eligible employees)

2017

80.7%

97%

85.6%

Oxford Health Insurance, Inc. Medical Loss Ratio (MLR)

Year

State MLR

Federal MLR - Small Group

(1 to 50 eligible employees)

Federal MLR – Large Group

(51+ eligible employees)

2017

80.6%

85.3%

88.1%

Oxford Health Plans (CT), Inc. Medical Loss Ratio (MLR)

Year

State MLR

Federal MLR - Small Group

(1 to 50 eligible employees)

Federal MLR – Large Group

(51+ eligible employees)

2017

68.3%

98.6%

88.9%

This information will also be posted to the UnitedHealthcare and Oxford broker portals: